Provider Demographics
NPI:1073348744
Name:MAHARAJ, KARLA YAZMIN (DDS)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:YAZMIN
Last Name:MAHARAJ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 HARBISON DR UNIT 1005
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-3934
Mailing Address - Country:US
Mailing Address - Phone:650-798-9029
Mailing Address - Fax:
Practice Address - Street 1:3501 HARBISON DR UNIT 1005
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-3934
Practice Address - Country:US
Practice Address - Phone:650-798-9029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110708122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist